Diabetes - tests to diagnose

Q:Is there any test to tell for sure you have Diabetes or not. I have a friend 32 years who was diagnosed as type 1 diabetic. He was put on Insulin for 3 months after that he stopped and it is almost 8 months since he has taken any Insulin and he BG levels are normal. His HbA1c was less around 5.5 in last 6 months. When they diagnosed him for diabetes they also checked his thyroid and found that he is producing less thyroxine. I was wondering if there is a way to confirm diabetes?

A:There are several tests like insulin antibodies, GAD antibodies, which tell you if you are at a higher risk for type 1 diabetes. The glucagon stimulatedC-peptide test can be done to check the level of insulin reserve in the body. However, these tests are not done routinely in India, and are quite expensive. Some labs offer to ship the samples to labs abroad with whom theyhave a tie-up, but I am never certain of the results or their reliability.

The best test is the blood glucose level itself. If your friend has needed insulin for 3 months, and is currently in the "honeymoon phase", he is likely to have high sugars again in the future. If his sugars are normal at present, I feel he should make sure * he has a balanced diet without excess fat or excess protein* he exercises regularly* he does not smoke or take too much alcohol* he tests blood sugar regularly, say once in 2-3 weeks, to detect a rising level early; and immediately on any suspicious symptoms like excess urine/thirst/ hunger/ weight loss or gain* he tests HbA1c regularly say every 3-4 months.* he checks BP regularly and keeps it below 120/ 80 mmHg.

In this way he can detect rising sugars early and have treatment started in time. Delaying treatment can lead to beta cell failure and hasten complete diabetes, as well as increase the risk of going into ketoacidosis and even coma.